A Case of Ileocecal Tuberculosis Presenting as Perforative Peritonitis

Karthikeyan Selvaraj¹ and Sairam KR²*
¹Associate Professor, Department of General Surgery, Sree Balaji Medical College &Hospital, Bharath University, Chennai
²Post Graduate, Department of General Surgery, Sree Balaji Medical College Hospital, Bharath University, Chennai
*Corresponding Author: Sairam KR, Post Graduate, Department of General Surgery, Sree Balaji Medical College Hospital, Bharath University, Chennai.

Published: June 20, 2023

DOI: 10.55162/MCMS.05.141

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Abstract  

     One of the most prevalent extrapulmonary tuberculoses is abdominal tuberculosis. In the past, drinking milk contaminated with Mycobacterium bovis was the main cause of intestinal tuberculosis. However, due to the ageing population and rising rates of human immunodeficiency virus infection, intestinal tuberculosis is now more common even in the absence of detectable lung disease.

     In 4.9% of cases, intestinal perforation is the first symptom of intestinal tuberculosis. Because of the reactive thickening of the peritoneum and the development of adhesions with the surrounding tissues, free intestinal perforation is a rare consequence. This explains situations with a 1-10% death rate and poor prognosis. Surgery is required immediately for peritonitis brought on by minor bowel perforation.

     Here we present a case of 25 year old female patient who presented to casualty with diffuse abdominal pain and decreased urine output. X-ray erect abdomen revealed air under diaphragm which was in favour of hollow viscus perforation. In view of this patient was taken up for emergency laparotomy which showed multiple ileocaecal perforations for which right hemi colectomy was done. Histopathology revealed granulomatous colitis in favour of Koch’s disease.

Keywords: intestinal tuberculosis; perforation; ileocaecal; peritonitis